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July 8, 2011

ARDMS Updates and Headlines in the News:

ARDMS: Important Testing Center Update

Credentials Continue To Play A Critical Role In Economic Recovery and Development of America's Workforce

Ultrasound Guided Liver Surgery Makes Tumor Removal Safer

Space Research Gives Birth To New Ultrasound Tool For Healthcare

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ARDMS: Important Testing Center Update

Important Testing Center Update: Due to heightened security measures for admission to the test centers, previously accepted forms of ID will not be accepted if the name on the ID does not exactly match the name on your ARDMS examination-confirmation letter.  If the names are different in any way (including a middle initial that appears on the ID but not in your record or vice versa) on either form of identification, you must update your name of record with ARDMS immediately. Failure to present two forms of identification that exactly match the name reflected on your Examination Confirmation Letter will result in you being turned away from the test center and being marked absent for the appointment. Should this occur, you will be required to submit a new online application form and testing fee in order to obtain a new eligibility period within which to examine.

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Credentials Continue to Play A Critical Role In Economic Recovery and Development of America's Workforce

As job openings across the nation call for employees to upgrade skill sets, professional credentials play a significant role in helping employers find the right people to fill those opportunities, while helping employees become established and advance in their careers.

In recognition of the growing need for highly skilled employees, President Obama recently announced an expansion of the Skills for America's Future program. This initiative partners community colleges with industries to ensure that the nation's workforce has the necessary skills and training to fill existing and future jobs in the manufacturing sector. For job seekers, securing recognized credentials that acknowledge their abilities can be critical to obtaining employment and advancing within their careers.

"Certification matters. Professional credentials provide employers and employees with recognition for the time and training undertaken to develop expertise within a specific field," said Melissa Murer Corrigan, President of the Institute for Credentialing Excellence (ICE). "Certification may positively impact company profitability and provide employees with nationally portable credentials that set them apart when seeking a new job or advancing within their current organization."

The White House's recent focus on building employee skills is timely, especially for the nation's manufacturing workforce. The sector has seen significant growth over the last two years, with more than 230,000 jobs created since the beginning of 2010. An aging manufacturing workforce is also driving the sense of urgency behind this effort.

Many current employees are likely to retire within the next 10 years. Without training and credentialing programs to prepare younger workers and acknowledge their abilities, the manufacturing sector will struggle to fill job openings with properly-skilled employees.

To help establish a credentialing system that is valued by employers, The Manufacturing Institute – the education and research affiliate of the National Association of Manufacturers ( NAM ) – recently partnered with a number of manufacturing firms and associations to create the NAM-Endorsed Manufacturing Skills Certification System. This program offers competency-based, customized education that leads to stackable, industry-recognized manufacturing credentials valued by a wide range of manufacturing employers throughout the nation. The broad reach of the Manufacturing Skills Certification System allows students and workers to access education through community colleges in 31 states.

"A skilled workforce is critical to our nation's economic recovery," said Emily Stover DeRocco, President of The Manufacturing Institute. "We are working with community colleges across the country to establish educational pathways that integrate the NAM-Endorsed Manufacturing Skills Certification System into for-credit programs of study to provide the skills needed most by local manufacturers. As employers recognize the value of the Manufacturing Skills Certification System, they can hire certified candidates with confidence while maintaining the quality of their products and the pace of their operations."

Credentials obtained through ICE Member organizations, or through programs such as the Manufacturing Skills Certification System, offer value for any individuals seeking to enter into or advance within a meaningful career in their industry of choice.

View the article online.

Article written by staff at credentialingexcellence.org and adapted for the purposes of this newsletter.

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Ultrasound Guided Liver Surgery Makes Tumor Removal Safer

ALOKA Holding Europe AG, the innovator in ultrasound, is working with the world renowned liver surgeon, Professor Guido Torzilli to explore the clinical benefits of intra-operative ultrasound in hepatic cancer cases. Ultrasound has one enormous advantage over traditional techniques, such as MRI and CT, since it can be used intra-operatively. The success of this alternative technique for hepatectomies translates into lower mortality rates; mortality rates are up to 5 times lower using ultrasound guided techniques than with traditional techniques.

Without ultrasound guided surgery, 35-50% of surgical cases require a major hepatectomy. However, using Torzilli’s technique means only 4% of surgical cases result in major hepatectomies. Prof. Torzilli said “making the need for major hepatectomies around 10 times less likely is a massive and positive step forward in the care of hepatic cancer patients.” Quality of life and independence are both reduced following a major hepatectomy, so there are further advantages in avoiding major hepatectomies.

There are three types of liver cancer; hepatocellular carcinomas, cholangiocarcinomas and metastatic tumors from colon cancer. All three can be treated with operations to remove the tumors, and, at least for metastatic cancers from colon cancer and cholangiocarcinomas, it is the only treatment which affords a chance of a cure. Prof. Torzilli said “chemotherapy, radiotherapy and other treatments can sometimes keep the cancer under control, but only the association with surgery makes feasible a curative perspective.”

Prof. Torzilli explained the problem: “Although the liver has a remarkable ability to regenerate itself, during operations to remove tumors, it is important to try and remove as little healthy liver tissue as possible, whilst still ensuring all the tumor is removed - to reduce the chance of further growth and relapses. It is this compromise between removing the tumor and sparing the liver tissue itself that I believe is optimized by the use of bespoke intra-operative ultrasound systems.”

Due to the metastatic properties of some forms of hepatic cancers, inoperable relapses can be common when tumors are removed using conventional techniques. In contrast, by operating conservatively in the first instance, a second round of surgery becomes a viable option as less tissue needs removing – meaning liver function can still be retained. Ultrasound is allowing previously unfeasible operations to go ahead, and this is saving lives.

Using a range of probes, Prof. Torzilli is able to give himself the best view at each stage. A convex probe allows him a wide view field to initially explore the area, a T-shaped probe provides resolution for superficial structures, and for guiding surgical maneuvers the Micro-Convex probe.

Prof. Torzilli said “Without ultrasound guidance we would never have been able to give these patients such a good chance of overcoming the cancer and retaining good liver function.” This technique is being built back into accepted practice with the training of the new generation of surgeons, and Prof. Torzilli strongly recommends that “all surgeons train in the intra-operative use of ultrasound for hepatectomies.”

View the article online.

Article written by staff at european-hosptal.com and adapted for the purposes of this newsletter.

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Space Research Gives Birth To New Ultrasound Tools For Healthcare

The remoteness and resource limitations of spaceflight pose a serious challenge to astronaut health care. One solution is ultrasound. Scientists with the National Space Biomedical Research Institute (NSBRI) have developed tools that expand the use of ultrasound during spaceflight and on Earth, especially in rural and underserved locations.

These tools include techniques that streamline training and help remote experts guide non-physician astronauts to perform ultrasound exams.

Ultrasound can be used to assess numerous conditions - fractured bones, collapsed lungs, kidney stones, organ damage and other ailments - in space and on Earth. With an NSBRI grant, they also created a catalog, or atlas, of “space-normal” imagery of the human body, setting the stage for astronauts to provide care without consulting a physician on Earth. This atlas was handed over to NASA earlier this year.

Dr. Scott A. Dulchavsky, the Roy D. McClure Chairman of Surgery and Surgeon-in-Chief at the Henry Ford Hospital in Detroit, is the principal investigator of these projects and is a member of the NSBRI Smart Systems and Technology Team.

“The ultrasound imagery techniques came from space program constraints of not having a trained radiologist on orbit or having a CAT scan or an MRI available, forcing us to use ultrasound for things in which we would not normally use it,” he said. “Also, time limitations forced us to put some tight brackets around what is absolutely required for training to be able to obtain a high-quality ultrasound image and to make some sense out of the image.”

Dulchavsky and colleagues from NSBRI, NASA, Henry Ford and Wyle Integrated Science and Engineering Group began their first ultrasound experiment - Advanced Diagnostic Ultrasound in Microgravity (ADUM) - by developing exam techniques for use on the International Space Station (ISS).

The goal was for ISS crewmembers to collect high-quality ultrasound images to send to the Mission Control Center for analysis. The ADUM research was split into two projects: NSBRI funded the ground portion of the research, while NASA supported the flight portion.

The researchers conducted 80 hours of ultrasound examinations on the ISS and then sifted through approximately 20,000 images and many hours of video collected during ISS Expeditions 8 through 12 to create the "space-normal" atlas. The researchers developed the intuitive ultrasound guide to give astronauts broader use of ultrasound in additional organ systems and medical problems that were not part of the ISS experiment.

Dulchavsky said, "ADUM initially utilized telemedicine and tele-ultrasound operations in which the astronauts were interacting with researchers and flight controllers on the ground during the examinations. The ultrasound intuitive guide allows astronauts to conduct exams when quick communication with an expert is not available due to distance from Earth or other reasons."

One of the first to be trained and to conduct an ultrasound exam in space was former NASA Astronaut and ISS Expedition 10 Commander Dr. Leroy Chiao. "We demonstrated on the International Space Station that even non-physicians can produce diagnostic-quality ultrasound images using remote guidance," said Chiao who is chairman of the NSBRI User Panel and a member of Baylor College of Medicine's Center for Space Medicine.

"These ultrasound exam techniques and atlas will be increasingly important as we venture farther and longer into space. Telemedicine using ultrasound will be an invaluable medical diagnostic tool."

The level of skill needed to accurately analyze ultrasound exam results will vary based on the exam's goal. "To diagnose a broken bone is relatively straight-forward. When we were trialing this at my we trained the custodial personnel to conduct exams. After about five minutes, they had a diagnostic accuracy in the high 90s," Dulchavsky said.

"Alternatively, if you are trying to look at subtle changes in how the heart functions in zero-gravity after six months, that takes considerably more expertise, and may take hours or even days of evaluation to do."

As in space, low costs and reduced-resource consumption make ultrasound an attractive option on Earth, but until recently, the lack of trained personnel has been an issue. Based on their research for NSBRI, Dulchavsky and his colleagues have spun off the techniques for terrestrial use and published The ICU Ultrasound Pocket Book - a reference guide for conducting examinations.

"The American College of Surgeons, which is charged with continuing of surgeons in our country, saw the methods we developed for space and has now incorporated these techniques in its ultrasound training courses for all of the surgeons in the United States," Dulchavsky said. "Similarly, medical schools are starting to incorporate this training for all medical students, not just surgeons."

The ultrasound imaging techniques are also being used by athletic trainers for some professional sports teams and the United States Olympic Committee to get point-of-care rapid information about athletes' injuries.

However, it is rural locations, both inside and outside the United States, that stand to gain the most from the diagnostic ultrasound capabilities and telemedicine. Dulchavsky has been collaborating with the World Interactive Network Focused on Critical UltraSound (WINFOCUS) to train individuals to use ultrasound techniques in under-served regions.

"The use of ultrasound truly enhances people's opportunities to access and provide accurate, immediate, cost-effective health care," said Dr. Luca Neri, director of the WINFOCUS Global Ultrasound Program, and scientific chair of the "Point-of-care Lombardia UltraSound" project at Niguarda Ca' Granda Hospital and AREU EMS Public Regional Company in Milan, Italy.

"Particularly, within the resource-scarce communities and health-care systems, we are successfully building upon the innovative ultrasound and telecommunication technologies developed by Dr. Dulchavsky for NSBRI and NASA and integrating their capabilities into the national health and education systems.

"By empowering local personnel to offer affordable, immediate, accurate, portable imaging, we facilitate earlier and more effective diagnosis, treatment and follow-up of on a broader basis and in a more sustainable manner."

Some of the countries in which the ultrasound techniques are being implemented to foster sustainable primary health-care development are Mozambique, Lesotho, Madagascar, India, Brazil and Nicaragua, with programs planned in Honduras, Congo and Malaysia.

Tele-ultrasound has also been performed by Dulchavsky's team on Mount Everest and in the high Arctic Circle. During the past four years, Dulchavsky and Neri gave regular updates about ultrasound potentials at the United Nations' Economic and Social Council and the Observatory for Cultural and Audiovisual Communication in the Mediterranean and in the World InfoPoverty conferences in Geneva and New York.

In addition to Dulchavsky's , the NSBRI Smart Medical Systems and Technology Team portfolio contains projects developing other innovative ultrasound technologies. One project is developing an ultrasound system to measure bone density and quality and accelerate fracture healing. Another project is developing a system for bloodless tumor removal, internal bleeding treatment and kidney stone reduction.

View the article online.

Article written by staff at spacedaily.com and adapted for the purposes of this newsletter.

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